POS1267 IGURATIMOD AS AN ALTERNATIVE THERAPY FOR SYSTEMIC SCLEROSIS AND PREVENTION OF ISCHEMIC DIGITAL ULCER OCCURRENCE
Authors: Q. Yan, B. Liu, J. Wang, H. Yin, Q. Li, L. Lu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis (SSc) is not only one of the autoimmune diseases with the highest mortality but rises a severe disease burden through some not directly lethal but suffering complications such as digital ulcers (DU) [1].Iguratimod(IGU) is typically thought of as an anti-inflammatory and immunoregulatory drug [2]. On top of anti-inflammation, IGU has shown potential efficacy on fibrotic complications with autoimmune diseases[3]. <h3>Objectives</h3> To assess the effectiveness of IGU as an alternative treatment for SSc, especially in the prevention of ischemic DU. <h3>Methods</h3> We constructed two cohorts from the Renji SSc registry. In the first cohort, SSc patients receiving IGU were observed prospectively with effectiveness and safety. In the second cohort, we picked up all the DU patients with at least a 3-month follow-up to investigate the prevention of IGU on ischemic DU. <h3>Results</h3> 1) IGU was a plausible alternative treatment for SSc with acceptable tolerance. 91.3% (21/23) of the SSc patients were disease worsening-free during IGU treatment (median follow-up: 61 weeks). 2) We unexpectedly discovered that IGU was protective against ischemic DU. Although with a limited patient number, 72.7% (8/11) of IGU-treated patients had no new DU occurrence in a median follow-up of 39 weeks; further in the second DU cohort (Table1), the protection of IGU was still true for new DU occurrence (adjusted RR = 0.25, 95% CI, 0.05-0.94, adjusted OR = 0.07, 95% CI, 0.01-0.49)(Figure 1). <h3>Conclusion</h3> Our study indicates IGU as a possible alternative treatment for SSc. Beyond expectation, this study for the first time describes IGU as preventative against ischemic DU occurrence and merits further investigation. <h3>References</h3> [1]Zelenietz C et al. Ann Rheum Dis. 2010;69(11):2055-6. [2]Jiang H et al. Biomedicine &amp; Pharmacotherapy. 2020;122:109704. [3]Yan Q et al. Ann Rheum Dis. 2019;78(Suppl 2):459. <h3>Authors' details</h3> Qingran Yan<sup>1</sup>, Bei Liu<sup>1</sup>, Jieying Wang<sup>2</sup>, Hanlin Yin<sup>1</sup>, Qianqian Li<sup>1</sup>, and Liangjing Lu<sup>1</sup> 1Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. 2 Clinical Center for Investigation, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. <h3>Acknowledgments</h3> This work was supported by the National Natural Science Foundation of China (81974251) and Shanghai Municipal Commission of Health and Family Planning (20204Y0088). <h3>Abstract number</h3> 435 <h3>Declaration of conflict of interest</h3> Qingran Yan: None declared, Bei Liu: None declared, Jieying Wang: None declared, Hanlin Yin: None declared, Qianqian Li: None declared, and Liangjing Lu: None declared. <h3> Acknowledgements</h3> This work was supported by the National Natural Science Foundation of China (81974251) and Shanghai Municipal Commission of Health and Family Planning (20204Y0088). <h3>Disclosure of Interests</h3> None Declared.